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Upper Instrumented Vertebrae (UIV) Tilt Angle Is an Important Postoperative Radiological Parameter That Correlates With Postoperative Neck and Medial Shoulder Imbalance

Study Design. Retrospective study. Objective. To investigate the association between postoperative upper instrumented vertebrae (UIV) tilt angle with postoperative medial shoulder and neck imbalance. Summary of Background Data. Studies had found that current recommendations for UIV selection were no...

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Main Authors: Chan, Chris Yin Wei, Chiu, Chee Kidd, Ler, Xin Yi, Ng, Yun Hui, Chian, Xue Han, Tan, Pheng Hian, Kwan, Mun Keong
Format: Article
Published: Lippincott, Williams & Wilkins 2018
Subjects:
R Medicine
Online Access:http://eprints.um.edu.my/22282/
https://doi.org/10.1097/BRS.0000000000002645
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spelling my.um.eprints.222822019-09-11T03:06:24Z http://eprints.um.edu.my/22282/ Upper Instrumented Vertebrae (UIV) Tilt Angle Is an Important Postoperative Radiological Parameter That Correlates With Postoperative Neck and Medial Shoulder Imbalance Chan, Chris Yin Wei Chiu, Chee Kidd Ler, Xin Yi Ng, Yun Hui Chian, Xue Han Tan, Pheng Hian Kwan, Mun Keong R Medicine Study Design. Retrospective study. Objective. To investigate the association between postoperative upper instrumented vertebrae (UIV) tilt angle with postoperative medial shoulder and neck imbalance. Summary of Background Data. Studies had found that current recommendations for UIV selection were not predictive of good postoperative shoulder balance. Methods. A total of 98 patients with adolescent idiopathic scoliosis with Lenke 1/2 curves who underwent posterior spinal fusion between 2013 and 2014 with minimum follow-up of 2 years were recruited. Radiological parameters: UIV tilt angle, T1 tilt, cervical axis, and clavicle angle were measured preoperatively, postoperatively, and at final follow-up. Results. Mean age was 16.2±6.2 years. Mean follow-up was 37.9±6.5 months. There were 73.5% Lenke 1 and 26.5% Lenke 2 curves. Significant factors affecting postoperative T1 Tilt were postoperative UIV tilt angle, preoperative T1 tilt, and preoperative UIV tilt angle. Postoperative UIV tilt angle and preoperative cervical axis were significant factors affecting cervical axis at final follow-up. UIV level was not significant independent factor that affected postoperative T1 tilt and cervical axis. There was strong correlation between postoperative UIV tilt angle and T1 tilt for the whole cohort (P<0.001), when UIV was at T2 (P<0.001), T3 (P<0.001), and T4 (P<0.001). Postoperative UIV tilt angle also had significant correlation with cervical axis when UIV was at T2 (P=0.021) and T3 (P=0.009). Conclusion. Postoperative UIV tilt angle was an independent factor, which had significant correlation with postoperative T1 tilt and cervical axis measurement. There was strong correlation between postoperative UIV tilt angle and T1 tilt for the whole cohort, when UIV was at T3 and T4. There was very strong correlation between postoperative UIV tilt angle and T1 tilt when UIV was at T2. There was also moderate and significant correlation between postoperative UIV tilt angle and cervical axis for the whole cohort. Lippincott, Williams & Wilkins 2018 Article PeerReviewed Chan, Chris Yin Wei and Chiu, Chee Kidd and Ler, Xin Yi and Ng, Yun Hui and Chian, Xue Han and Tan, Pheng Hian and Kwan, Mun Keong (2018) Upper Instrumented Vertebrae (UIV) Tilt Angle Is an Important Postoperative Radiological Parameter That Correlates With Postoperative Neck and Medial Shoulder Imbalance. SPINE, 43 (19). E1143-E1151. ISSN 0362-2436 https://doi.org/10.1097/BRS.0000000000002645 doi:10.1097/BRS.0000000000002645
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine
spellingShingle R Medicine
Chan, Chris Yin Wei
Chiu, Chee Kidd
Ler, Xin Yi
Ng, Yun Hui
Chian, Xue Han
Tan, Pheng Hian
Kwan, Mun Keong
Upper Instrumented Vertebrae (UIV) Tilt Angle Is an Important Postoperative Radiological Parameter That Correlates With Postoperative Neck and Medial Shoulder Imbalance
description Study Design. Retrospective study. Objective. To investigate the association between postoperative upper instrumented vertebrae (UIV) tilt angle with postoperative medial shoulder and neck imbalance. Summary of Background Data. Studies had found that current recommendations for UIV selection were not predictive of good postoperative shoulder balance. Methods. A total of 98 patients with adolescent idiopathic scoliosis with Lenke 1/2 curves who underwent posterior spinal fusion between 2013 and 2014 with minimum follow-up of 2 years were recruited. Radiological parameters: UIV tilt angle, T1 tilt, cervical axis, and clavicle angle were measured preoperatively, postoperatively, and at final follow-up. Results. Mean age was 16.2±6.2 years. Mean follow-up was 37.9±6.5 months. There were 73.5% Lenke 1 and 26.5% Lenke 2 curves. Significant factors affecting postoperative T1 Tilt were postoperative UIV tilt angle, preoperative T1 tilt, and preoperative UIV tilt angle. Postoperative UIV tilt angle and preoperative cervical axis were significant factors affecting cervical axis at final follow-up. UIV level was not significant independent factor that affected postoperative T1 tilt and cervical axis. There was strong correlation between postoperative UIV tilt angle and T1 tilt for the whole cohort (P<0.001), when UIV was at T2 (P<0.001), T3 (P<0.001), and T4 (P<0.001). Postoperative UIV tilt angle also had significant correlation with cervical axis when UIV was at T2 (P=0.021) and T3 (P=0.009). Conclusion. Postoperative UIV tilt angle was an independent factor, which had significant correlation with postoperative T1 tilt and cervical axis measurement. There was strong correlation between postoperative UIV tilt angle and T1 tilt for the whole cohort, when UIV was at T3 and T4. There was very strong correlation between postoperative UIV tilt angle and T1 tilt when UIV was at T2. There was also moderate and significant correlation between postoperative UIV tilt angle and cervical axis for the whole cohort.
format Article
author Chan, Chris Yin Wei
Chiu, Chee Kidd
Ler, Xin Yi
Ng, Yun Hui
Chian, Xue Han
Tan, Pheng Hian
Kwan, Mun Keong
author_facet Chan, Chris Yin Wei
Chiu, Chee Kidd
Ler, Xin Yi
Ng, Yun Hui
Chian, Xue Han
Tan, Pheng Hian
Kwan, Mun Keong
author_sort Chan, Chris Yin Wei
title Upper Instrumented Vertebrae (UIV) Tilt Angle Is an Important Postoperative Radiological Parameter That Correlates With Postoperative Neck and Medial Shoulder Imbalance
title_short Upper Instrumented Vertebrae (UIV) Tilt Angle Is an Important Postoperative Radiological Parameter That Correlates With Postoperative Neck and Medial Shoulder Imbalance
title_full Upper Instrumented Vertebrae (UIV) Tilt Angle Is an Important Postoperative Radiological Parameter That Correlates With Postoperative Neck and Medial Shoulder Imbalance
title_fullStr Upper Instrumented Vertebrae (UIV) Tilt Angle Is an Important Postoperative Radiological Parameter That Correlates With Postoperative Neck and Medial Shoulder Imbalance
title_full_unstemmed Upper Instrumented Vertebrae (UIV) Tilt Angle Is an Important Postoperative Radiological Parameter That Correlates With Postoperative Neck and Medial Shoulder Imbalance
title_sort upper instrumented vertebrae (uiv) tilt angle is an important postoperative radiological parameter that correlates with postoperative neck and medial shoulder imbalance
publisher Lippincott, Williams & Wilkins
publishDate 2018
url http://eprints.um.edu.my/22282/
https://doi.org/10.1097/BRS.0000000000002645
_version_ 1646210196398145536
score 13.211869

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